Alan Gonzalez-Zapata

Scapula fracture and os acromiale after reverse total shoulder arthroplasty.

An 80-year-old woman underwent a right reverse total shoulder arthroplasty for cuff tear arthropathy with no complications. She was discharged 3 days after surgery with well-controlled pain. However, 6 days postoperatively, she reported the onset of excruciating pain in her right shoulder, and conventional radiographs, including an axillary radiograph, were obtained.

Intact Rotator Cuff

Reverse total shoulder arthroplasty was designed for patients with an absent rotator cuff and painful arthritis of the shoulder. In some of these patients, the glenoid bone is deficient and is treated with bone grafting or reaming the glenoid to a flatter surface. In our experience, reverse shoulder arthroplasty could be successful in patients without bone grafting. The success of reverse total arthroplasty in this population led to the use of this prosthesis in patients with severe bone loss and an intact rotator cuff. We have treated 34 patients with type A2, B2, and C glenoids with a reverse total shoulder without bone grafting the glenoid. Despite the concerns that there was minimal bone for the baseplate, there was only one case of glenoid loosening. Similarly, additional medialization did not affect postoperative range of motion or function in these patients. However, it should be noted that this study was limited to only one type of reverse prosthesis, which has a central screw on the baseplate and not a peg.

Amerika Birleşik Devletleri ve Avrupa’da ortopedi asistan eğitimi: İnternet üzerinden eğitimin rolü var mı?

Orthopaedic resident education is an evolving and continuously changing paradigm. Recently, the issue of resident work hours and, more specifically, work hour limits has received increased attention in medical education. The Accreditation Committee for Graduate Medical Education (ACGME) in the United States specifically limits the work week to 80 hours.[1] Meanwhile, in the European Union, the European Working Time Directive, limits the work week to 48 hours.[1] Reaction to work-hour regulations has been mixed with some of them underlying that reducing resident work-hours would compromise residents training.[2–5]

Stress Reaction of the Humerus in a High School Baseball Player

The patient was an 18-year-old high school baseball pitcher with a chief complaint of right (dominant) arm pain in the region of his right distal humerus that began 8 weeks earlier. Conventional radiographs were obtained, which were interpreted as normal. As a result, magnetic resonance imaging was obtained, which showed a hyperintense bone marrow signal in the distal humerus on fluid-sensitive sequences, which was consistent with a stress reaction of the distal humerus.